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양측성 거대결절성 부신피질 과증식에 기인한 쿠싱증후군 1예
남순우,손태서,장상아,차봉연,이광우,손호영,강성구 대한내과학회 1997 대한내과학회지 Vol.53 No.3S
쿠싱증후군을 나타내는 결절성 과증식은 매우 드문 질환으로 저자들은 내분비학적, 방사선학적 및 조직학적으로 규명된 양측성 결절성 과증식에 의한 쿠싱증후군 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Cushing's syndrome due to macronodular adrenal hyperplasia comprises a clinical and biochemically heterogenous group of disorders whose pathogenesis is unclear. Opinion has differed as to whether this condition represents a primary hypothalamic pituitary defect, primary adrenal autonomy or combination of both. We describe a patient with atypical steroid dynamics and with bilateral macronodular hyperplasia(combined adrenal gland weight 176gm). Patient had elevated 24hour urinary free cortisol and cortisol levels that were not suppressed by high dose dexamethasone. Adrenal CT revealed marked enlarged nodular adrenal gland and sella CT revealed a pituitary microadenoma. Bilateral adrenaletomy was performed. The both adrenal glands showed all the pathologic features of macronodular hyperplasia.
남순우,이인석,문성배,송기호,강무일,차봉연,이광우,손호영,강성구 대한내과학회 1997 대한내과학회지 Vol.53 No.3S
임신성 당뇨병은 임신중 처음 발견되는 당뇨병으로서 대부분 임신의 종료와 함께 회복되는 것이 특징이며, 당뇨병성 케톤산증의 발생은 매우 드문 것으로 되어 있다. 최근에 저자들은 26세, 임신 36주의 산모에서 임신성 당뇨병에 의한 당뇨병성 케톤산증을 경험하였다. 임신 27주 이후에 임신성 당뇨병의 진단 및 치료가 이루어지지 않은 결과로써 결국 사산과 당뇨병성 케톤상증이 발생 되었다. Gestational diabetes mellitus is a self-limiting disorder of pregnant woman, which mostly returns to normal state after delivery. Diabetic ketoacidosis occurrs very rarely in gestational diabetes patients, and is harmful to fetal and maternal health. A 26-year-old pregnant woman was transferred from a private clinic. Because of dyspnea after cesarean section of dead fetus of 36+5 weeks, the clinical history, physical examination, and laboratory data were suitable to diagnose diabetic ketoacidosis. She received the management of fluid supplement and insulin therapy, and then she was soon recovered from ketoacidosis state. After delivery, she is being treated with sulfonylurea at outpatient department.
남순우,백종태,강상범,이동수,김진일,조세현,박수헌,한준열,안병민,김재광,정규원 대한간학회 2005 Clinical and Molecular Hepatology(대한간학회지) Vol.11 No.4
A 28-year-old female with a pregnant state of 29th gestational week was admitted because of nausea and vomiting. MRI showed a huge hepatocellular carcinoma. At the 36th gestational week, a normal delivery was done. Surgery of hepatocellular carcinoma was done at 20 days after delivery. After 22 months from the operation, pulmonary metastasis was found and resection of lung mass was done. About 3 years after resection, a low attenuating nodule was detected in the left atrial chamber of heart. We report a case of hepatocellular carcinoma with metastatic lesions to lung and heart in a pregnant woman. 임신 29주째의 28세 여자 환자가 오심과 구토를 주소로 입원하였다. 자기공명영상검사 결과 간세포암종이 발견되었고 임신 기간을 36주까지 연장한 후 출산을 시행하였다. 출산 20일 후에 간세포암종의 외과적 절제술이 시행되었다. 외래 추적 검사 중 수술 22개월 후에 폐로의 전이가 발견되었고 전산화단층촬영 유도하조직생검에서 확인되어 폐 종괴에 대한 수술이 시행되었다. 수술 시행 3년 후에 심장의 좌심방에서 저음영의 종괴가 발견되어 심장초음파, 폐혈관조영술 및 흉부외과적 절제술을 시행하여 전이된 간세포암종을 진단하였다. 그 후, 수개월간의 방사선치료 및 보존적 치료에 반응하지 않고 환자는 다발성 장기부전으로 사망하였다. 저자들은 임신한 여성에서 발생된 간세포암종이 폐로 전이된 후 좌심방으로 전이된 증례를 경험하여 보고한다.
대한간학회지 제8차 춘계학술대회 초록집 : 구연 ; 최소증상 간성 뇌증 환자에서 신경인지검사의 유용성 연구
남순우 ( Nam Sun U ),양동원 ( Yang Dong Won ),김지훈 ( Kim Ji Hun ),김창환 ( Kim Chang Hwan ),김진일 ( Kim Jin Il ),박수헌 ( Park Su Heon ),한준열 ( Han Jun Yeol ),김재광 ( Kim Jae Gwang ),정규원 ( Jeong Gyu Won ),선희식 ( Seon Hu 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.2(S)
최소 증상 간성 뇌증에서 신경인지검사와 뇌 자기공명분광검사의 유용성
남순우 ( Nam Soon Woo ),김진일 ( Kim Jin Il ),박수헌 ( Park Soo Heon ),한남익 ( Han Nam Ik ),한준열 ( Han Joon Yeol ),안병민 ( Ahn Byung Min ),김재광 ( Kim Jae Kwang ),최상욱 ( Choi Sang Wook ),정규원 ( Chung Kyu Won ),선희식 ( Su 대한소화기학회 2003 대한소화기학회지 Vol.42 No.1
Background/Aims: The aim of the study was to correlate neuropsychological test results with regional cerebral biochemistry determined by magnetic resonance spectroscopy (MRS) in patients with minimal hepatic encephalopathy (MHE). Methods: The patients with liver disease were divided into 4 groups; group 1 chronic hepatitis; group 2, liver cirrhosis (LC) without a history of HE; group 3, LC with a history of HE of no manifestation, and group 4, LC with overt HE. All patients were examined using neuropsychological tests and brain MRS. Results: Trail making, Digit span, Digit symbol, and Peg board test in groups 2 and 3 were significantly different compared with control. These neuropsychological tests were regarded more available test for diagnosis of MHE. In the LC patients, compared with control, MRS results showed a typical pattern with decrease of myoinositol/Cr (0.24±0.24 vs. 0.68±0.10, p<0.05) and increased glutamine-glutamate/Cr (2.97±0.80 vs. 1.94±0.47, p<0.05). The difference of myoinositol/Cr and glutamine-glutamate/Cr between patients with MHE and control was statistically significant (0.16±0.15 vs. 0.68±0.10, 3.11±0.72 vs. 1.94±0.47, p<0.05). Conclusions: Neuropsychological tests and MRS maybe useful for diagnosing MHE. (Korean J Gastroenterol 2003;42:50-56)